Advised to supplement by hv? Your words of wisdom please...

[winterland]

Evening all. My baby is 10 weeks old today. Exclusively breast fed. She feeds 2 hourly through the day, sometimes 3. Sleeps through from 11 to 6am.
At birth she weighed 7lb 1 . She dipped and then by 6 weeks she was 8lb 3. Had her weighed today and she has gone down to 8lb but grown 2 cm in length. So in a month she has lost 3 oz. she does look very skinny but then, so are her brother and sister.

Predictably the hv has told me to start following each bf with formula. But won't this affect my supply? I absolutely do not want to give up bf, or supplement at all really but not sure what to do. She does have a very minor tongue tie which she has been referred to the hosp for but not sure of this is relevant?

Any words of wisdom? The hv is ringing me tomorrow to find out my decision....

I would also agree with others thatt have said to feed more often if possible. When dd was small I was told she should have at least 10 feeds in 24hrs.

I think it's only eight because it takes so long! Bf or 40- 50 mins then bottle for however long it takes to finish, then expressing..

When my DD wasn't putting in weight I was advised to breastfeed her for up to 30 minutes and then topup with either expressed milk or formula. If she's breastfeeding for 50 minutes each time and then gets a bottle baby may be burning more calories.

I can't offer any advice on the practical side of things (pregnant with my first) but you said in a previous post that your family were making unhelpful comments about her looking happier after her FF. Its worth pointing out if they say this kind of thing again and you don't strangle them immediately that she is looking happier because she is full and that if you could fill her up on breast milk at every feed then you would and she'd be happy with that. There is nothing wrong with the quality of your milk.

After the advice to wean a baby under 8lbs, I'd be asking to see a different health visitor in future and putting in a complaint. I'm not saying that a health visitor shouldn't be concerned about the weight loss, of course they should, but it is ridiculous to suggest that solids would be better than breastmilk and formula.

The fact that she doesn't seem to be gaining on formula top ups (unless its just too early to tell, I'm not an expert) suggests that it may never have been a problem with your breastmilk/let down/breasts. She may be ill. I think you need to see a doctor about this, not a health visitor who is obviously clutching at straws if she has gone from 'Breastfeeding is the problem, Formula is the answer' to 'Ah well, Milk of any kind is the problem, Solids are the answer' in such a short period of time.

I'm not saying that top-ups aren't part of the solution for you and dd, a doctor may even agree that they'd rather see how much she's eating (so ebm and ff rather than breastfeeding) but there could be a medical reason for her not putting on weight. If a doctor can't find anything else wrong, then I think it would be worth having the TT sorted. Okay, its not a severe one so may not help, but as she has feeding difficulties with both breast and bottle, there really ought to be no harm in trying it.

If you are worried about her going 'off' the breast whilst doing topups even if they are necessary to monitor her feeding, you could get an at breast supplimentor as mentioned above.

Try to get some more supportive help than that HV and find a way of relaxing, this stress on you both probably isn't helping.

I think Spiritedwolf has given some great advice. I was thinking some of the same things earlier but was posting on my phone and have trouble posting longer messages on it.

Also the fact that your DD has put on weight in the past then lost does suggest possibly something else is going on. Is it a paediatrician that you are under now? I think you should push for more help.

OP, have you considered a private TT division - a number of lactation consultants offer this service. And depending on where you are in the country, there may be more than one hospital you can access - many of the hospitals listed on the UNICEF Baby Friendly website will take out of area referral. Milk Matters are probably a good starting point.

can you express from one side while feeding from the other?
it's a bit annoying till you get used to it, but it does save time

Had a look on milk matters etc but I'm in Scotland and there's no one up here. Will check the other one though. And yep I'm getting to grips with expressing and feeding in tandem.

I've found she feeds better when
My boobs are really full - would fenugreek increase supply do you think?

Winter where are you roughly in Scotland. I know a few bf counsellors one might be near you I could put you I touch with them.pm me if you don't want to post on the thread.

I'm in the borders

not sure about what will help.

keep expressing, i suppose.
(the more you use tthe more you make)

do you squeeze when you're feeding her?
as if you're massaging your boob?
that might make it feel more full to her.

Ok I'm in west Lothian so probably a bit far out for my friends but I'll ask if they know anyone nearer. Have to been to the hospital bf clinic yet? They should have info on peer supporters for your area.

I know you want to continue bfing, but please don't make yourself or your dd unwell to keep going. I'm concerned even with the formula top ups she is still not gaining weight. Have any other HCPs seen her other than the Hv in the last week or so?

I agree with the other posters - you need to be referred to a paediatrician. The HV is out of her depth here.

Off the bf clinic on Monday. I've been referred to the paediatrician. She's been really good but the appts take so long. She doesn't seem to think its urgent but she is concerned obv that she hasn't managed to put on despite the formula. They are checking for thyroid probs, reflux, and a myriad of other things. She's very pro bf, and has alot of experience with breasts and surgery too. She's told me to express every feed and measure how much I'm getting. But expressing isn't that easy and sometimes I get none. But my dd does get some.. To be honest I'm getting closer to quitting all together ..

You've done really well to continue this long. I think see how well you get on with the clinic on Monday.

Also since she has not gained yet with the formula top ups I would hold on with feeding her just a little longer as you don't want to find out it is something else and you've given up bfing for nothing.

glad you've got a Paed who understands the importance of BF, too.

I'm not saying it's more important than making sure your baby's growing, but I mean she's not one who goes "well, just use formula" like some do.

I hope nothing is wrong, just that she's slow to catch on to this nourishment lark.

and yes, I agree, keep doing what you're doing while you find out what's up.
(and expressing can be hard - sometimes that's why expressing while feeding onthe other side works, because you're using the natural let down from the baby's hard work. )

Do you have a expressing bra? I cut holes in an old bra to fit the shields through so I could express hands free. With the telly on and my laptop on my knee to mn it really helped. You can buy specific ones but if you have and old greying one that is just about done. Just don't cut the holes too big, I had to sew mine up a wee bit. And you can double pump if you aren't feeding at the same time.

Dh renamed our study the milking shed whilst I was expressing! Keep doing what you are doing and reassess once you seen the paed. You are doing so well. :)